MyMedR

Fulltext Multiple coronary artery bypass grafting in dextrocardia: case report

Wong PS, Chong CL

Med J Malaysia, 1999 Dec;54(4):514-6.

This is a case report of an unusual case of a patient with dextrocardia and "situs inversus totalis" who presented with unstable angina. Coronary angiography revealed severe main stem and severe triple vessel coronary artery disease. The patient later underwent successful emergency coronary artery bypass graft surgery. To the authors' knowledge this is the first reported case in Malaysia and also, the first ever report in the literature of multiple vessel coronary artery grafting, including the use of the right internal mammary artery.

Sevoflurane induction in acute airway obstruction

Chiu CL, Delilkan AE

Hosp Med, 1998 Oct;59(10):828.

PMID: 9850310

Trace monitoring of water-borne phenolics in the Klang River Basin

Tan GH, Chong CL

Environ Monit Assess, 1993 Feb;24(3):267-77.

PMID: 24227384 DOI: 10.1007/BF00545983

The Klang River Basin is located in the most densely populated region in Malaysia, with its heavy concentration of industries and population. A systematic study of the pollution to this river system caused by phenolic compounds have been carried out under this project. Analyses of water samples from the Klang River by high performance liquid chromatography (HPLC) with an ultraviolet (UV) detector at 280 nm have shown the presence of some priority phenolic pollutants.

HLA-DQ alpha genotype and allele frequencies in Malays, Chinese, and Indians in the Malaysian population

Koh CL, Benjamin DG

Hum. Hered., 1994 May-Jun;44(3):150-5.

PMID: 8039798

The HLA-DQ alpha genotype and allele frequencies in 130 Malays, 125 Chinese, and 137 Indians in the Malaysian population were determined using a commercial HLA-DQ alpha DNA amplification and typing kit which distinguishes 6 alleles (DQA1.1, DQA1.2, DQA1.3, DQA2, DQA3, and DQA4) and 21 possible genotypes at this locus. All 21 genotypes were encountered in the Malay and Indian samples, but DQA1.1,DQA1.3 and DQA2,DQA2 genotypes were absent in the Chinese sample. In all three ethnic groups, the numbers observed for the various DQ alpha genotypes were in accordance with those expected from Hardy-Weinberg equilibrium. The allele frequencies observed in these three groups were significantly different to allow them to be distinguished as distinct populations. For the Malays, Chinese, and Indians, heterozygosity values at this locus were 0.77, 0.77, and 0.83, respectively, and values of the power of discrimination were 0.91, 0.90, and 0.94, respectively. These population data will enable the HLA-DQ alpha locus to be used as a marker in forensic identity testing in Malaysia.

Bullous contact allergy from cinnamon

Goh CL, Ng SK

Derm Beruf Umwelt, 1988 Nov-Dec;36(6):186-7.

PMID: 3069433

A young Malay female presented with a bullous eruption as a manifestation of contact allergy to cinnamic aldehyde in cinnamon. The clinical and histological features resembled bullous pemphigoid but immunological markers for pemphigoid were absent. The patient responded to a short course of oral steroids. Contact allergy can mimic pemphigoid.

Antimicrobial resistance and conjugative R plasmids in Escherichia coli strains isolated from animals in Peninsular Malaysia

Koh CL, Kok CH

Southeast Asian J. Trop. Med. Public Health, 1984 Mar;15(1):37-43.

PMID: 6377513

Fifteen independent E. coli strains of avian, bovine and porcine origin in Peninsular Malaysia were tested for antibiotic resistance and conjugative R plasmids. Eight (53%) isolates were found to be antibiotic resistant. Among them, 37.5% were mono-resistant and 62.5% were resistant to three or more antibiotics, i.e., multi-resistant. All of them were resistant to Tc and sensitive to Gm and Nx. Three of the eight antibiotic resistant strains were able to transfer all or part of their resistance to an E. coli K12 recipient by conjugation. The transfer frequencies of Km, Sm and Tc resistance of the three donors varied between 4.5 X 10(-8) to 6.8 X 10(-7). Analysis of the plasmid profiles of all the three donors and their respective transconjugants after agarose gel electrophoresis provided conclusive evidence that the transferable resistance traits were plasmid-mediated.

Nonconjugative R plasmid-mediated antibiotic resistance in Escherichia coli isolated from animals in Peninsular Malaysia

Koh CL, Kok CH

Southeast Asian J. Trop. Med. Public Health, 1984 Sep;15(3):313-6.

PMID: 6395350

Four of the five veterinary E. coli strains, which were unable to transfer their antibiotic resistance by conjugation, were found to harbour plasmids. Evidence from transformation, agarose gel electrophoresis and curing experiments showed that in strains KE-3, KE-4 and KE-14 a nonconjugative R plasmid carried the gene for resistance to tetracycline. The plasmids in KE-9 were cryptic.

Fulltext Serum alpha-i acid glycoprotein in thyroid dysfunctions

Ho CL, Cheah JS

Med J Malaysia, 1982 Mar;37(1):70-1.

PMID: 7121352

The serum alpha-1 acid glycoprotein of 9 euthyroid subjects, 14 hypothyroid patients and 21 hyperthyroid patients was determined by radial immunodiffussion in agar plates. The serum alpha1 acid glycoprotein level in both the hypothyroid and hyperthyroid patients were significantly lowered when compared to the euthyroid subjects. There was no significant correlation between the alpha-1 acid glycoprotein level mid the Liothyronine resin uptake (T3 resin. uptake) and the serum total Thyroxine Iodide (T4I) level.

An evaluation of the modified Airway Management Device

Chiu CL, Wang CY

Anaesth Intensive Care, 2004 Feb;32(1):77-80.

PMID: 15058125

This is a preliminary report on the use of the modified Airway Management Device in 50 spontaneously breathing patients undergoing elective day care surgery. We were successful in establishing a clear airway in all 50 patients, 46 of these patients had a patient airway on the first attempt. All patients were successfully managed with the Airway Management Device throughout the surgery. Partial airway obstruction during maintenance of anaesthesia occurred in three cases requiring only minor manipulations. Our result showed that the Airway Management Device may be used as an alternative airway management in anaesthesia.

Acropustulosis (acrodermatitis continua) with resorption of terminal phalanges

Adam BA, Loh CL

Med J Malaya, 1972 Sep;27(1):30-2.

PMID: 4264822

Nerve conduction velocities and distal latencies in normal Malaysian subjects

Lim CL, Loh TG

Med J Malaysia, 1978 Dec;33(2):137-42.

PMID: 755164

Fulltext Reminder: Interpret the "Science" with Caution

Kow RY, Low CL

Malays Orthop J, 2020 Jul;14(2):157.

PMID: 32983397 DOI: 10.5704/MOJ.2007.027

Fulltext Arthrofibrosis after Anterior Cruciate Ligament Reconstruction: The Devil is in the Detail

Kow RY, Low CL

Malays Orthop J, 2020 Nov;14(3):204-205.

PMID: 33403089 DOI: 10.5704/MOJ.2011.036

Fulltext Phenotypic and genotypic identification of hard ticks of the genus Haemaphysalis (Acari: Ixodidae) in Peninsular Malaysia

Ernieenor FCL, Ernna G, Mariana A

Exp Appl Acarol, 2017 Apr;71(4):387-400.

PMID: 28409404 DOI: 10.1007/s10493-017-0120-3

Morphotaxonomy based on phenotypic traits of immature hard ticks (Acari: Ixodidae) is a skill challenge and has prompted many inexperienced acarologists to adopt DNA-based methods for identifying and discriminating the species. The aim of this study is therefore to utilize COI gene for verifying the morphological status of Haemaphysalis ticks in Peninsular Malaysia. A total of 19 on-host ticks collected from four localities were first identified using specific illustrated taxonomic keys that lead to the genus of Haemaphysalis. Genotypic traits of tick species were then verified molecularly based on cytochrome oxidase subunit I (COI) gene using polymerase chain reaction and direct sequencing. Clustering analysis was carried out by constructing a phylogenetic tree to determine the genetic variation and diversity of local Haemaphysalis ticks. Based on external morphological characterizations, all immature ticks were successfully identified down to the genus level only. Molecular analysis of the genotypic using COI gene revealed 16 individuals (84%) as Haemaphysalis hystricis, and three individuals as H. humerosa with sequence homology of 97-99 and 86-87%, respectively. Haemaphysalis hystricis were clustered in their respective monophyletic group in the phylogeny trees with a bootstrap of 100%. Furthermore, a low intraspecific variation (<0.3%) was observed among Malaysian H. hystricis but high interspecific value (>15%) recorded. This study morphologically and molecularly confirms the presence of H. hystricis in Malaysia and the findings will add value to the existing knowledge in identification of ticks in this country.

Fulltext Modified One-third Tubular Plate with Hook for Distal Lateral Malleolus Fracture Fixation

Kow RY, Low CL

Malays Orthop J, 2019 Mar;13(1):60-61.

PMID: 31001388 DOI: 10.5704/MOJ.1903.013

The role of acute internal medicine service in handling burden of medical access block in a tertiary hospital, Hospital Melaka experience

Adznan NUH, Gan CL

Med J Malaysia, 2021 Jan;76(1):68-72.

PMID: 33510112

INTRODUCTION: Access block is a major problem faced by most hospitals. It has led to congestions in emergency departments (ED) leading to sub-optimal or delayed treatment. Inevitably the spotlight falls on medical department, being accountable for the highest proportion of access block in ED.

MATERIALS AND METHODS: This is a retrospective study looking at data collected during office hours on 79 working days, excluding weekends and public holidays in Hospital Melaka, Malaysia. Details on all medical access block cases that were reviewed were recorded including their locations, diagnosis, disposition decisions and if they received specialist input at the time of their initial assessment by the medical team in ED. The aim is to revolutionise patient admission flow by offering early specialist care with rapid assessment, investigation and treatment. Hence, improving the overall treatment efficiency and reduce medical access block.

RESULTS: There were 1321 admissions. A total of 82% of the patients were admitted to the medical wards while 13% of them were given acute treatment in ED and discharged home with appropriate follow ups. We managed to resolve 18% of medical access block by re-triaging our cases and offering timely acute medical treatment. Nearly 90% of patients received first hand medical specialist input during the initial assessment by the Acute Internal Medicine (AIM) team in ED.

CONCLUSION: The significant resolution in medical access block with active screening, re-triaging and management of patients by the AIM team allows a more optimal hospital bed management. Patients also receive timely access to medical intervention with specialist care and stable patients can benefit from early supported discharge.

Psychotherapeutic management of a potential spirit medium

Woon TH, Teoh CL

Aust N Z J Psychiatry, 1976 Mar;10(1A):125-8.

PMID: 1065324

Psychotherapeutic management of a potential spirit medium (shaman) in a modern University Hospital setting in Malaysia is described. Magical thinking, projection and spirit possession (trance state) occur during management. Discussion of management was based on what Heinz Wolff described as the psychotherapist's functions of (1) psychodynamic understanding; (2) the therapeutic function; and (3) the developmental function. This patient did not conform to the general criteria of a suitable patient for psychotherapy. But her willingness to engage in therapy contributed to a satisfactory outcome. The therapist's growth in cross-cultural therapeutic encounter seems to be prominent.

Heights and weights of a sample of Malaysian children

Tan PC, Wong CL

Med J Malaya, 1969 Sep;24(1):12-7.

PMID: 4243835

Fulltext Do statins adversely affect the HbA1c of diabetic patients?

Son WD, Teng CL

Malays Fam Physician, 2017;12(1):39-40.

PMID: 28503276

This paper discusses the adverse effect of statins on the HbA1c levels of diabetic patients. Studies have shown that statins may slightly worsen the HbA1c level. The effects vary depending on the type of statins, the dosage and the duration of therapy. However, it has been confirmed that statin use has benefits that outweigh its harms. Therefore, a diabetic patient should be given advice on the need for appropriate lifestyle changes and the importance of continuing the statins.

Fulltext Hepatoprotective Effects of Morinda citrifolia Leaf Extract on Ovariectomized Rats Fed with Thermoxidized Palm Oil Diet: Evidence at Histological and Ultrastructural Level

Chong CLG, Hussan F, Othman F

Oxid Med Cell Longev, 2019;2019:9714302.

PMID: 31827717 DOI: 10.1155/2019/9714302

Morinda citrifolia (Rubiaceae) or Noni was previously reported to have leaf with broad therapeutic property whereas the fruit was rarely described as medicinal. Ironically, extensive research and review has been done on the fruit and little was known about the therapeutic activity of the leaf as a medicinal food. The aim of this study was to investigate the therapeutic effects of Morinda citrifolia (MC) ethanolic leaf extract on the hepatic structure and function in postmenopausal rats fed with thermoxidized palm oil (TPO) diet. Thirty eight female Sprague Dawley rats were divided into five groups: sham (Sham), ovariectomized (OVX), ovariectomized and treated with simvastatin 10 mg/kg (OVX+ST), ovariectomized and supplemented with low dose MC 500 mg/kg (OVX+MCLD), and ovariectomized and supplemented with high dose MC 1000 mg/kg (OVX+MCHD). All the ovariectomized groups were fed with TPO diet whereas the Sham group was fed with normal diet. Consumption of TPO diet in postmenopausal rats resulted in obesity, significantly elevated (P < 0.05) liver oxidative stress marker; malondialdehyde (MDA), diffuse microvesicular steatosis, and defective mitochondria. Treatment with MC leaf extract prevented hepatic steatosis by significantly increasing (P < 0.05) the liver antioxidant enzyme SOD and GPx, significantly increasing (P < 0.05) ALP, decreasing liver lipids infiltration, preventing mitochondrial damage, and overall maintaining the normal liver histology and ultrastructure. In conclusion, we provided detailed histological and ultrastructural evidence showing hepatoprotective effects of MC leaf extract through its antioxidant mechanism.

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